August 20, 2018

Colorado Court of Appeals: Workers’ Compensation Claimant Need Only Prove Either Wage Loss or Disability for TPD

The Colorado Court of Appeals issued its opinion in Montoya v. Industrial Claim Appeals Office on Thursday, February 2, 2018.

Workers’ Compensation—Medical Incapacity—Temporary Partial Disability.

Claimant worked as an interior designer for Ethan Allen Retail, Inc. Her pay was based entirely on commissions. Claimant suffered admitted work-related injuries. Although she was neither given work restrictions nor medically limited in her ability to work, her medical appointments caused her to be absent from the showroom floor and not be able to meet potential and current clients. Claimant sought temporary partial disability benefits (TPD) in a workers’ compensation action. She testified that the absences caused her to lose more than $20,000 in commission earnings. The administrative law judge (ALJ) awarded claimant TPD benefits to compensate her for the commissions she lost while attending medical appointments.

A panel of the Industrial Claim Appeals Office (Panel) set aside the award of TPD benefits, reasoning that disability benefits are only available if a claimant demonstrates both medical incapacity and temporary loss of wage earning capacity. Here, because the ALJ had found that claimant had no work restrictions and was able to perform her job duties, the Panel held she did not establish the requisite “medical incapacity” prong of disability and therefore, as a matter of law, was not entitled to receive TPD benefits.

On appeal, claimant contended that the Panel’s interpretation of “disability” was too narrow. The court of appeals concluded that although the concept of disability incorporates both “medical incapacity” and “loss of wage earnings,” a claimant need not prove both components to establish entitlement to disability benefits under the Workers’ Compensation Act. The court then found that the evidence presented amply supported the ALJ’s finding that claimant’s wage loss was attributable to her work-related injury. The Panel erred in setting aside the ALJ’s decision.

The Panel’s decision was set aside and the case was remanded with instructions.

Summary provided courtesy of Colorado Lawyer.